C16 pt 2 Flashcards

1
Q

Intestinal encephalopathy
- sometimes seen in a horse with what condition?
- similar to what?

A

o Sometimes seen in horses with colitis (excess production of ammonia in the colon?)
o Similar to hepatic encephalopathy

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2
Q

Rectal prolapse
- associated with?
- possible sequelae?
- species specific causes for pig, dog, sheep

A

o Any species, often associated with straining or increased abdominal pressure (ex.
urinary obstruction, coughing)
o Prolapsed segment becomes edematous and ischemic, may slough
o Sloughing may result in stricture
<><>
- Pig: Zearalenone toxicity from Fusarium spp. mold
- Dog: Brachycephalics predisposed
- sheep: Excessively short docking predisposes

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3
Q

Jejunal hematoma (AKA hemorrhagic bowel syndrome) in cows
- signalment?
- outcome?
- appearance?

A

o Adult dairy cows, usually causes sudden death but cause is unknown
o Loops of jejunum obstructed by mural hemorrhage, often sharply demarcated
o Affected segments often have mucosal tears that allow blood into the lumen

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4
Q

Duodenitis-proximal jejunitis (AKA proximal enteritis) in the horse
- what is it?
- may lead to?
- what does it cause?

A

o Upper SI ileus of unknown cause
o Fibrinous enteritis or ulceration of the duodenum, variable extent but spares ileum
o May lead to stricture in chronic cases and may cause peritonitis
o Causes depression, nasogastric reflux, gastric distention and ulceration, occasionally
gastric rupture

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5
Q

Diagnosing GI disease
* Generating a suitable list of differential diagnoses requires you to know:

A

species and age

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6
Q

Mixed infections are common and often different agents produce the same clinical
disease = ______ diarrhea (until a cause is identified)

A

undifferentiated

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7
Q

Diagnosing GI disease
* Many agents are transient or cause lesions that are easily obscured by autolysis
- what is it important to examine to make this less of an issue?

A

o Examining live, untreated animals early in the course of disease is important!

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8
Q

A modified postmortem approach is used in enteric disease to ensure….

A

…to ensure sections of the gut are fixed in formalin ASAP
o Normally we work from ‘clean to dirty’; in these cases we go straight to the gut

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9
Q

good type of scraping for diagnosing GI diseases

A
  • Some diseases (ex. cryptosporidiosis, coccidia) can be diagnosed from mucosal scrapings
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10
Q

peritoneum
- surface area
- lined by?
- damage and healing?
- how does it heal?
- what growth abnormalities are common?

A
  • Larger surface area than skin, lined by mesothelium
    o Easily damaged but heals rapidly via free-floating progenitors
    o Healing is even through defect (not edges in)
    o Hyperplasia/metaplasia common, can look neoplastic
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11
Q

Peritoneum and retroperitoneum
- involved in what functions?
- what is the retroperitoneum?
- disease in peritoneal cavity usually secondary to what?
- general fluid amount? ante vs post mortem?

A
  • Involved in lubrication, immune surveillance, regulation of inflammation and healing
    <><><><>
  • Retroperitoneum refers to all structures between the peritoneum and dorsal muscles
    o Blood vessels, nerves, connective tissue, adipose (good place to see serous atrophy)
    <><><><>
  • Disease is usually secondary to problems with the organs in the peritoneal cavity
    <><><><>
  • Usually little fluid, must differentiate antemortem effusions from postmortem
    accumulation (red-tinged, does not clot)
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12
Q

Ascites
- what type of fluid?
- 2 mechanism of development
- what can make it worse?

A
  • Excess fluid, usually modified transudate (watery, clear, straw coloured)
    o Two mechanisms of development…
    <><><><>
  • Excess production
    o Increased hydrostatic pressures in hepatic and portal circulation
    o Most commonly due to fibrosis and congestive heart failure
    o Or, leakage of chylous fluid from cisterna chyli
    <><>
  • Insufficient removal
    o Obstructed lymphatic drainage to thorax
    o Ex. carcinomatosis, space-occupying lesion in thorax
    <><><><>
  • Sodium retention and hypoproteinemia due to liver disease can make ascites worse
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13
Q

Congenital pleuroperitoneal diaphragmatic hernia
- most common in what species?
- issues?

A

o Most common in dogs
o Herniation of organs into chest can cause respiratory distress, incarceration

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14
Q

Peritoneopericardial diaphragmatic hernia
- usually in what animals?
- how does it happen?
- possible outcomes?

A

o More common form, usually seen in small animals and may have other defects
o Diaphragm does not fuse or fails to develop properly
o Clinically silent or organ herniation causes cardiac tamponade

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15
Q

Possible consequences of blunt trauma:

A

Contusions
- Often skin or subcutaneous lesions line up with organ contusions
<><>
Mesenteric/vascular avulsion
- Causes hemorrhage, infarction
<><>
Capsular fracture of solid organs
- Causes hemorrhage, pallor, splenic contraction, splenosis if spleen damaged
<><>
Hollow organ rupture (bladder, gut, uterus, etc)
- Releases contents, can cause peritonitis; in pregnant females, released fetuses will die and cause peritonitis if not removed
<><>
Acquired hernia
- Often diaphragmatic as the diaphragm is weaker than the abdominal wall

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16
Q

why are bladder ruptures hard to find?
- uroperitoneum looks like what? how to differentiate?

A
  • Bladder ruptures are hard to find, as the bladder contracts as urine leaks
    o Uroperitoneum looks like ascites – compare creatinine level to serum to confirm
17
Q

Acquired diaphragmatic hernias
- must confirm what?
- in SA, usually what structure?
- progression and signs?
- in horses, usually what structure and signs?

A

o Must confirm the hernia developed antemortem (fibrin, hemorrhage, etc)
o In small animals, usually muscular diaphragm
o May be subclinical at first but progresses to respiratory distress, tympany, obstruction,
or abnormal fluid accumulation in the thorax +/- abdomen
o In horses, usually tendinous diaphragm, causes colic rather than respiratory distress

18
Q

Uroperitoneum
- causes? in neonates?

A

o Usually due to urolithiasis, in neonates caused by bladder rupture (especially foals)

19
Q

Digesta in abdomen
- cause? species most commonly affected?
- location
- why can it be hard to find?
- Rectal perforation in horses: cause?
- MUST CONFIRM WHAT? how?

A

o GI rupture or perforation, most common in horses and cattle
o Can occur anywhere due to foreign bodies, impaction, devitalization
o Site of leakage may be hard to find if there is peritonitis
o Rectal perforation in horses: often iatrogenic, sometimes during parturition
o MUST CONFIRM IF ANTEMORTEM! (hemorrhage, exudate, inflammation)

20
Q

Pneumoperitoneum
- cause

A

o Perforated body wall or intestine
most common

21
Q

Hemoperitoneum
- character?
- spontaneous reasons?

A

o May be fluid or partly clotted,
traumatic or spontaneous
o Spontaneous: splenic torsion +/-
rupture, GDV, coagulopathy, tumours, ruptured uterus or uterine artery in mares

22
Q

Abdominal fat necrosis
- associated with what condition in SA?
- appearance?

A
  • In small animals, associated with pancreatitis
    o White spots with red borders
23
Q

Massive abdominal fat necrosis
- signalment
- what happens
- possible issues?

A

o Poorly understood condition of older, fat, channel island cows
(Jersey, Guernsey)
o Multifocal to coalescing masses of necrotic fat (firm, dry, chalky)
o Often incidental but can cause fatal compression or obstruction of other organs

24
Q

Steatitis
- what is it?
- related to?

A

o Peroxidation of adipose throughout the body causes painful inflammation
o Related to high PUFA, low tocopherol diets (vitamin E deficiency in rancid fatty diets)

25
Peritonitis - species? - character?
* Common in large animals, rare in companion animals o Variety of types of exudate based on cause o Most cases are secondary but some agents cause primary infectious peritonitis o May be acute or chronic, local or diffuse, septic or not
26
Chemical peritonitis - can be caused by?
o Surgical glove powder (granulomatous), bile, pancreatic enzymes (localized)
27
Bacterial peritonitis - causes?
o Direct penetration, GI rupture/devitalization, extension from female reproductive tract o May also extend from an inflammatory nidus (ex. umbilical abscess)
28
peritonitis in the horse - features - healing - cause - type
- Usually diffuse, acute, fatal - Small omentum and poor healing capacity - GI rupture most common cause - Localized possible with castration, mesenteric Streptococcus abscesses
29
peritonitis in cattle - features - immune system - causes - sequelae - neonates causes
- Acute, diffuse, fibrinopurulent progressing to chronic, fibrotic - Excellent at walling off inflammation and forming abscesses - Usually due to GI or reproductive tract perforation - Chronic disease can lead to vagus indigestion - Hardware disease may involve the pericardium - In neonates, may extend from umbilical infection
30
peritonitis in small ruminants - cause?
Ruptured caseous lymphadenitis lesions or reproductive origin
31
peritonitis in pigs? - features - causes
- Serofibrinous - Commonly due to Glasser’s disease (polyserositis), also septicemic bacteria (Streptococcus suis, Mycoplasma spp., Trueperella pyogenes)
32
periotnitis in dogs cause
Usually hollow organ contamination or bacteremia, bacteria vary
33
peritonitis in cats? - features - cause
- Mostly fibrinopurulent - FIP pyogranulomatous - Ruptured pyometra, penetrating wounds, Actinomyces spp.
34
Peritonitis - consequences
* Ileus: supports development of adhesions * Electrolyte and fluid sequestration in peritoneum and gut * Absorption of bacterial toxins into lymphatics (may be fatal before gross lesions develop) <><> * Possible outcomes of peritonitis 1) Resolution 2) Persistence in localized regions (abscesses) 3) Fibrosis <><> * Fibrin that is not removed by 3-4 days becomes organized into fibrosis o Effect of adhesions depends on location (subclinical, obstruction, or stenosis) o Ischemia, foreign material, necrosis, and sepsis all promote fibrosis
35
Mesothelioma - common? - malignant? - species? - hard to tell from what? - spread? - effects? - appearance?
Mesothelioma: rare, always malignant, most common in cattle and dogs o Hard to tell apart from reactive mesothelium o Spread by implantation (not necessarily metastasis), often blocks lymphatics (ascites) o Can affect peritoneum, pleura, and pericardium simultaneously o Variable gross appearance, can resemble peritonitis or carcinoma
36
Lipomas (peritoneal) - common? - age/species? - when problematic - metastatic? - appearance?
* Lipomas: most common peritoneal interstitial tumour, especially old horses o Problem if mesenteric lipomas become pedunculated (why?) o Always benign, often have a friable necrotic core
37
what cancers can implant on peritoneum? - primary tumour locations?
* Carcinomas and less commonly sarcomas can implant on peritoneum o Look for the primary tumour o Ovarian, biliary, pancreatic, intestinal, prostatic, renal carcinomas o Gastric squamous cell carcinoma, transitional cell carcinoma o Melanoma in grey horses and occasionally dogs, etc etc
38
parasites in the peritoneum - why? - which ones?
* Parasites are mostly accidental or on their way somewhere else o Migrating flukes can cause peritonitis in ruminants o Setaria spp. nematodes are incidental inhabitants of the ruminant peritoneum o Larval cestodes and errant Dioctophyme renale are usually incidental